A new return-to-work study glaringly illustrates some of the problems with getting quick, appropriate medical care to injured workers. It also shows a substantial percentage of injured workers are not being shown how to do their jobs safely to prevent reinjury.

The research from the Workers Compensation Research Institute was the latest in an ongoing series based on thousands of interviews of injured workers in 15 states. It showed the following:

• One year after the injury, up to 18 percent of injured workers had not been able to return to work for at least a full month.
• Three years after the injury, up to 15 percent of injured workers had still not been able to return to work for at least a month.
• Up to 19 percent of injured workers who did return to work had a subsequent absence due to the same injury.

The last statistic is probably the most staggering, as it shows almost one-fifth of injured workers may be reinjuring themselves on the job. In many cases, this is likely due to a lack of understanding of how to perform their job tasks correctly. Instead, many of them go back to work and do their jobs the same way they did before — which led to the injury in the first place.

Here is a sampling of the RTW percentages for three of the latest states studied:

• Indiana:10 percent of injured workers had no substantial RTW (at least 1 full month) predominantly due to the injury 3 years post-injury, and 11 percent reported no substantial return to work within one year of the injury.
• Virginia:14 percent of injured workers had no substantial return to work as of 3 years post-injury, and 17 percent reported no substantial return to work within one year of the injury.
• Wisconsin:12 percent of Wisconsin injured workers did not return to work for at least a one-month period as of three years post-injury, and 13 percent reported no substantial return to work within one year of the injury.

The Role of PT

Physical therapists can play a significant role in helping to reduce the statistics noted above. It is incumbent upon payers in the workers’ compensation system to get PT to their injured workers as soon after an injury as possible, and to ensure the therapist spends time working with the injured worker showing him how to do his job in a way that prevents reinjuries.

The most effective and efficient way to do this is by providing PT at the actual worksite — even if the injured worker is not yet able to perform any of his job tasks. Doing the PT in the actual place of business allows the therapist to see specifically what the worker is required to do, the equipment he uses, and the space involved. Knowing the injuries the worker is experiencing and understanding what is expected of him does two things:

1. Gives the therapist a clear understanding of how the worker was injured in the first place and what he needs to do to prevent reinjuring that body part once he is able to return to work.
2. Allows the therapist to show the worker the proper way to perform his job in the future.

We often find that other workers in the area can benefit from the therapist’s expertise, as they too are shown the most ergonomically safe ways to do their job tasks.

Deterrents to Care

Another set of statistics from the study was also telling. It showed a significant percentage of injured workers reported ’big problems’ getting the desired medical services they or their primary care physician wanted. Some of this can be explained as disagreements about whether the desired care was actually necessary, according to the employer or insurer. However, two of the reasons listed stand out:

• They could not get an appointment soon enough.
• Travel was difficult to arrange.

Despite all the evidence showing the value of early access to appropriate medical care, there are still too many delays. Study after study has shown that getting treatment to the injured worker as soon as possible leads to better outcomes, quicker returns-to-work, and lower overall costs to the payer.

Travel should not be an issue. Savvier providers are increasingly willing to go to the injured worker’s job site or his home, when a clinic is not convenient. For physical therapy, going to the worksite should be the first consideration to deliver treatment.

Conclusion

Keeping an injured worker on the job in some capacity is always optimal — if the worker is able to get to the job and perform any sort of light- or modified-duty. Short of that, getting them healed and back on the job soon is next. But it’s critical that the injured worker understands what he can and cannot do to stay safe and healthy — for the worker, the employer and the payer.